REIMBURSEMENT OF EMERGENCY MEDICAL COSTS

Staab v. McDonald, docket no. 14-0957 (Apr. 8, 2016)

HELD: VA is required to reimburse the costs for emergency medical treatment “when coverage by a third party [including Medicare] is less than total.”

In other words, partial Medicare reimbursement does not bar VA reimbursement for the uncovered medical expenses. VA’s regulation stating that VA will only reimburse when a “veteran has no coverage under a [third-party] health-plan contract” is invalid because it is inconsistent with the 2009 amendment to 38 U.S.C. § 1725. 

FULL DECISION